CMS Releases MA Rate Notice
CMS released the final 2027 Medicare Advantage Rate Notice. The rule included an overall expected average change of 2.48%. This was revised from the proposed rule’s average change of 0.09%. CMS estimates the change equals about $13 billion in additional payments to Medicare Advantage organizations.
CMS Releases ACA Data
CMS released detailed 2026 ACA Open Enrollment data. Overall plan selections declined 5% year over year. The new consumer plan selections declined 13% year over year. One notable change, as a result of statutory changes and buydowns 43% of Healthcare.gov consumers are in plans eligible for HSAs. In 2025 that figure was 2%.
Eyes on Nebraska
The first state to implement Medicaid work requirements, Nebraska, is scheduled to launch its work requirements on May 1. Many observers are closely watching the state, as its experience could be predictive for how other states will implement work requirements. CMS is not expected to release formal guidance on work requirements until June, according to Modern healthcare ($). All states must implement work requirements by January 1, 2027.
Potential Democrat Health Policies
The Center for American Progress, an influential Democratic leaning think tank, released key policy goals around health care. These ideas could inform future policy agendas for Democrats, should they gain political power in D.C. The ideas included a federal rate review process for all fully insured plans, limiting hospital prices in concentrated markets, changing ACA MLR requirements, and replacing prior authorization reviews with independent clinical reviews.
DOJ Litigation
A lawsuit worth monitoring is the Department of Justice’s recent lawsuit suing New York-Presbyterian over alleged anticompetitive contract restrictions. Combined with last month’s lawsuit aimed at OhioHealth, there may be a trend emerging from DOJ targeting health system pricing practices. This may give more leverage to insurers in pricing negotiations.
